Maintaining patient medical records, whether for an individual doctor or for the entire medical staff of a major hospital, presents many complications, which may be grouped broadly into three categories.
First, pertinent information for any one patient may come from an array of sources, including physical and medical history information provided by the patient, radiology reports, clinical and anatomical pathology reports, EKG readouts, physician orders, nursing notes, care plans, and insurance providers.
Second, upon discharge, a patient's medical record data is typically reviewed extensively. This includes reviews of the physician's attestation, of documentation of the treatment process, of all charts to ensure that they are complete, and of procedures and notes to be abstracted. If data is incomplete, payment organizations such as insurers may deny claims made by a health care provider.
Third, any number of parties require access to patient information, including hospitals, clinics, attorneys, regulatory agencies, courts, whoever pays the bills, and naturally the patients themselves. Keeping track of requests for access from these varied sources is quite burdensome.
Most medical record systems in use today are either paper-based or make use of computer systems only to a limited extent. Optical imaging systems have been used to scan printed documents into a computer system for storage, retrieval, viewing, and printing, but these systems do not provide the management functions needed to deal effectively with the myriad tasks described above. Health care providers are finding that existing systems and methods of managing medical records are not meeting demands placed upon them.
In particular, two administrative bottlenecks in the use of such systems are the coding/abstracting of medical records and the assigning of deficient medical records (e.g., missing data or signatures) to proper personnel for completion.
Existing systems typically store documents in a database on a file server to which a plurality of client workstations are attached. Standard database functions may be used in such systems to establish workflow assignments. But such a database-centered approach to workflow has disadvantages. Because databases are not specifically structured to accommodate the types of transactions required for workflow processing, using standard database functions to carry out such transactions would be inefficient, resulting in unacceptable system performance. This is especially so if sophisticated workflow processing functions are implemented, such as a prioritized assignment of work to particular personnel based on predetermined criteria to specify which employees will receive particular types of work.
A system that allows sophisticated workflow processing while maintaining acceptable system performance would be useful. In addition, in view of the present use of optical imaging technology for data input to the records system, it would be desirable to use such technology in a more automatic system.